Objective: To compare the effect of combined endoscopic sphincterotomy (EST) and laparoscopic cholecystectomy (LC) with combined  laparoscopic choledocholithotomyTtube drainage (LCHTD) and LC for the treatment of cholecystolithiasis and choledochothiasis.
 Methods: We retrospectively analyed the clinical data of patients with cholecystolithiasis and choledocholithiasis  treated by EST combined with LC（468 cases）,and by LCHTD combined with LC（268 cases）. The stoneclearance rates,complication rate, conversion rate of open operation and hospital length of stay in the two groups were compared.
 Results: The stoneclearance rate was 97.2%(455/468) in the EST+LC group compared with 97.4%(261/268) in the LCHTD+LC group, and difference was no statistical (P>0.05).But the complication rate was 6.4% in the EST+LC group compared with 1.5% in the LCHTD+LC group, and  difference  was obvious (P<0.01). Hospital length of stay was a median of 15 days in the EST+LC group,and 10 days in the LCHTD+LC group. The longterm effect of LCHTD+LC group (96.6%) was better than that of EST+LC group(90.6%)(P<0.01).
 Conclusions: EST combined with LC is technically easier, however LCHTD is much harder to handle,but the effect of LCHTD combined with LC is superior to that of EST with LC. For patients with cholecystolithiasis and choledochliothiasis, the treatment method of choice must be individualized.